Global Burden of Cardiovascular Diseases

In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged and has been previously described in detail elsewhere. By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. More than 80 percent of the deaths occurred in low and middle income countries (WHO, 2009e).

Based on 2007 to 2010 data, 33% of US adults ≥ 20 years of age have hypertension. This represents ~ 78 million US adults with hypertension. The prevalence of hypertension is similar for men and women. African American adults have among the highest prevalence of hypertension (44%) in the world.

Dr. Heather A. Liska, from the Medical University of South Carolina in Charleston, and colleagues analyzed data from nearly 9,000 subjects who participated in the National Health and Nutrition Examination Survey I between 1971 and 1975. The subjects were followed for 18 years for major cardiovascular events.

Individuals with prehypertension had a 32 percent increased risk of cardiovascular disease. One or more cardiovascular risk factors were noted in 93 percent of those with prehypertension.

Further analysis showed that only the highest pressures in the prehypertension category raised the risk of cardiovascular disease. For example, a systolic pressure of 130 to 139 mm Hg or a diastolic pressure of 85 to 89 mm Hg increased the risk by 42 percent compared with those normal blood pressure levels, whereas lower prehypertensive pressures did not have a significant effect.

By comparison, subjects with overt hypertension had more than double the risk of having a major cardiovascular event compared with those with normal blood pressure, the investigators point out.

“With current knowledge alone, Prehypertension? should serve as an early warning system for patients and clinicians that metabolic changes which ultimately lead to cardiovascular disease may well be underway,” Liska’s team concludes.

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